The lesson of the Ebola outbreak

Just six months ago, the director of the National Institutes of Health warned that a decade of budget stresses was causing the NIH to reject half the worthwhile research proposals it received. Scientific progress was in jeopardy, Francis Collins told the USA Today editorial board. Researchers were considering leaving the U.S. for careers overseas.

Are we now paying for that negligence? Last weekend, as a second U.S. case of the Ebola virus was diagnosed in Dallas, Collins told the Huffington Post that researchers likely would have discovered a vaccine for the disease by now if not for those budget cuts.

“NIH has been working on Ebola vaccines since 2001. It’s not like we suddenly woke up and thought, ‘Oh my gosh, we should have something ready here,’” Collins said. “Frankly, if we had not gone through our 10-year slide in research support, we probably would have had a vaccine in time for this that would’ve gone through clinical trials and would have been ready.”

With an annual budget that’s about the same as it was a decade ago, the NIH has about 23 percent less purchasing power now because of inflation. The agency also lost $1.7 billion in funding because of sequestration cuts in 2013, and scientists were told to put their research on hold during the 16-day government shutdown in October.

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Congress made up for at least some of the NIH sequestration cuts with its December 2013 budget, but budget pressures remain thanks to lawmakers’ troubling lack of foresight about the value of biomedical research.

This is not a partisan issue. Both parties willingly entered into the sequester agreement, and NIH funding has remained largely flat through two administrations. Now, Collins says the agency has had to “take dollars that would’ve gone to something else” to intensify research for a backup Ebola vaccine in case vaccines further down the research pipeline fail to answer the crisis.

What might those redirected research dollars have produced, in the short or long term? No one can say, of course, and that’s the root of the NIH’s budget problems. Congress has become too reactive with research funding, waiting until crisis arrives to fully consider its importance. (The last bump in NIH money came after the SARS outbreak a decade ago.)

The NIH is a wellness program of sorts, working now to protect against future crisis. It also fills in the research holes left by the for-profit pharmaceutical industry, which tends to focus its dollars on pursuing lucrative patents, not research with high rates of failure.

None of which is designed to help immediate threats like Ebola. For now, the Obama administration has charted a reasonable path, intensifying screening at five U.S. airports while focusing money and troops on helping West African countries build infrastructure to better contain the outbreak.

Meanwhile, vaccines are on the way – we hope quickly enough to prevent a larger epidemic. We hope, too, that lawmakers learn that the best time for prevention is years before the next Ebola threatens us.